How Worried Should Parents Be About Parechovirus?

Parechovirus is not a new virus, but it is the subject of a recent CDC health alert due to a possible spike in infant cases. The virus can cause serious illness in very young children. So how worried should parents be?

What is parechovirus?

“Parechovirus infections are common in childhood,” notes the American Pediatrics Association in a news article . Most children experience it even before they go to kindergarten. Typical symptoms in toddlers and preschool children are fever, rash, and respiratory symptoms.

The virus can spread through the respiratory and gastrointestinal tracts. (Or, in terms of what children do, it can be spread through coughs and sneezes, or when a child puts something in their mouth with traces of fecal germs.) The virus is most prevalent in summer and fall.

Usually, parechovirus is just one of many mysterious viruses that children catch and cure quickly. But in young children, some viruses can cause very serious illness, and parechovirus is one of them. The CDC reports that “infants under 3 months of age may experience severe illness, including sepsis, seizures, and meningitis or meningoencephalitis, especially in infants under 1 month of age.”

Why is parechovirus in the news?

The CDC has noticed several cases of parechovirus in recent months, and all of the cases tested were of the type known as PeV-A3, which tends to cause more severe symptoms than other strains. But does this mean that this virus is more common than usual, or that the cases are more severe than usual? We do not know.

“Because there is currently no systematic surveillance for PeV [parechoviruses] in the United States, it is unclear how the number of PeV cases reported in 2022 compares to previous seasons,” the CDC said in a statement. Children are also not routinely tested for parechovirus, so we do not know how many cases occur in children who are only mildly ill or who contract the virus without becoming ill at all.

How do I know if my child has parechovirus?

If your child only has mild symptoms, you will probably never know for sure if it was parechovirus. Remember, this is a common childhood virus. As infectious disease specialist Claire Bocchini told USA Today , “Children who are otherwise fine with a mild illness, we don’t test them for everything. It’s very expensive and it doesn’t change management.” (Management is like how you deal with a virus. If the result is just to keep the baby comfortable and wait it out, it doesn’t really matter what kind of virus it is.)

It’s a completely different story with babies. The CDC alert mentions that parechovirus is of particular concern in children under 3 months of age, where it can potentially be fatal. But the health alert they have posted is for health care providers, not parents. The message essentially tells doctors that they should put parechovirus on their list of possibilities when considering what might be wrong with a seriously ill infant.

“In this age group, any child with a fever should have a screening that includes, at a minimum, a blood test by age 60,” says Heather Jumbo, a New York City emergency room pediatrician. They stressed that parents should seek medical attention for a child at an early age with a fever, regardless of the suspected cause. In these first months of life, the American Pediatric Association considers a temperature of 100.4 to be a fever deserving immediate medical attention.

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